Hepatitis A is spread through contact with an infected person's feces. It can be spread from unwashed hands to food or objects and also through sex or shared needles used for injecting drugs. It can be fatal.

“Prevention is always more cost effective and will keep the community healthy,” clinic director and infectious disease Dr. Andrew Desruisseau said. “I think we’re at an unprecedented level of this epidemic, which started in San Diego.”

The Hepatitis A outbreak began last year in San Diego with some 460 cases and 17 deaths. The state health department said more than half of the cases were spread among the homeless. The epidemic traveled to Santa Cruz and most recently Los Angeles.

Doctors explained some people may not know they have Hepatitis A for a month. The most at risk are the homeless, drug users, men who have gay sex and those with a preexisting liver disease.

“Getting vaccinated is one piece of the prevention puzzle,” Dr. Desruisseau said. “The main prevention should still be focused on hand sanitation.”

If you’ve had the vaccine, or if you’ve had Hepatitis A, you’re considered immune for life. New shots are given twice, six months apart.

With the disease so easily spread and symptoms unseen for weeks, it could be likely that cases could crop up in the Bay Area. That is why the clinic in San Francisco is taking a proactive approach.

“It’s the right thing to do and from a public health perspective – it’s essential,” Desruisseau said.

Tenderloin Health Services plans to hold another free Hepatitis A vaccine clinic Friday, October 6 from 1 to 4 p.m. at its office at 330 Ellis Street.